Epidemiology, Risk Factors, and Pregnancy Outcomes in Peripartum Cardiomyopathy

Introduction: Peripartum cardiomyopathy (PPCM) is an acute life-threatening heart failure of indeterminate cause in pregnancy and postpartum. The global incidence varies depending upon the geographic location, racial features, and genetic predisposition. The present study was conducted to understand the incidence, risk factors, and pregnancy outcomes in PPCM. Methodology: This study was a 5-year retrospective case–control study of PPCM conducted at KAHER’s Dr Prabhakar Kore Hospital and Research Centre, Belagavi, between from January 1 st , 2018, to December 31 st , 2022. The risk factors and materno-fetal outcomes of the cases were compared with controls. Results: The incidence of PPCM was 2.38 per 1000 deliveries. The mean age was 26.55 ± 4.23 years. About 36.73% of cases were second gravida and 95.92% were singleton pregnancies. Preeclampsia and anemia were the most common associated risk factors. The odds of having PPCM are 4.97 (95% confidence interval [CI]: 1.31–18.94) times and 7.62 (95% CI: 1.61–36.19) times higher for preeclampsia and anemia, respectively, in women with PPCM. Lower segment cesarean section was the most common mode of delivery among the cases. Intensive care unit admissions, prolonged hospital stays, and maternal mortality were significant maternal outcomes. Neonatal outcomes did not vary significantly among cases and controls. Conclusion: The incidence of PPCM was found to be 2.38 per 1000 deliveries. PPCM was commonly seen in younger multiparous women with singleton pregnancies. Preeclampsia and anemia in pregnancy were important modifiable risk factors associated with PPCM. Medical management requires special consideration in pregnancy and lactation. Maternal outcomes were poorer in cases which presented postnatally. Lower birth weight was significant perinatal outcome noted. Cardio-obstetric team approach is needed in almost all cases.